Friday, June 02, 2006

VICTORIA - It's no big thing that the government is going to have schools teach students about respect for gays and lesbians, says Attorney General Wally Oppal."This really is a classic case of much ado about little or nothing," he said. "I mean, we're 2006 now and we're still concerned about whether or not we should be acknowledging the contributions made by homosexuals? Why should that be controversial?"Oppal's right. But the government's actions - under the NDP and the Liberals - indicate this is significant.The B.C. government announced plans this week to introduce a new Grade 12 elective course that will “explore the nature of a just and equitable society by focusing on social justice issues.” The elective course will look at the economic, legal, political and ethical issues around race, gender and sexual orientation. And government promised a gradual review of the entire school curriculum over the next few years to make sure it “reflects inclusion and respect for the diverse groups that today make up B.C.'s population.” Laudable and necessary. But Oppal's claim that this isn't a significant change doesn't really stand up.The government didn't just decide to introduce these changes. They are part of the negotiated settlement of a human rights complaint , one government has been fighting since 1999. That's when Murray and Peter Corren, a Vancouver couple, alleged systemic discrimination against gays and lesbians in the school system. Only now has the government accepted the need for change.Even the announcement of the changes showed that this was unusual. The people who write government press releases are normally required to make sure the minister's name is mentioned in the first two paragraphs. A manufactured quote - often clunky - has to be include by paragraph three.No minister's name made it into this release at all.Despite the government's edginess, this is a good and overdue change.The new curriculum need not interfere with anyone's right to disapprove of homosexuality, or of people from a different country or race. Peoples' thoughts are their own. But it will increase understanding. And it will teach the reality that B.C. and Canada are diverse places and we need to have the knowledge and respect to let us live and work together successfully.While there's been progress, we have far to go. Three Liberal MLAs toured the province in 2003 as a Safe Schools Task Force. “In nearly every community visited, no matter how large or small, individuals made presentations about the issue of harassment and intimidation based on sexual orientation," they reported. "Even the perception of being homosexual or of being tolerant of homosexuality is enough to result in harassment and intimidation, including both emotional and physical abuse.”Students reported being bullied and harassed for the colour of their skin, their religion or their ethnic background.It is wrong that children face discrimination in school, and it is immoral and foolish to allow people to graduate with little respect for others.B.C. is becoming an increasingly diverse place. Statistics Canada forecasts that by 2017 visible minorities - largely from Asia - will be in the majority in Vancouver. Across the province one-third of the population will be visible minorities.That's an asset, as Premier Gordon Campbell has noted. The diversity brings cultural richness and can help B.C. become a centre for global business.But it brings challenges and schools must play a large role in dealing with them.It's not a question of moralizing or brainwashing. Students need to know about the legal bars against discrimination in Canada and why they exist. They need to learn about the ethical and economic aspects of diversity. They need to move beyond cliche and stereotype. All of those things should be part of the school system from a very early stage.The changes announced this week are a small step, but a significant one. School will be a better place for many students, and B.C. will be a better place for the next generation.Footnote: The new Grade 12 course will be ready for testing in the 2007-8 school year and introduced the year after that. Changes to of the rest of the curriculum will take place over several years as part of the normal reviews that the education ministry conducts. But slow or not, the changes are a great tribute to the Correns' persistence.

Wednesday, May 31, 2006

VICTORIA - There’s no reason to set your hair on fire about the principles behind the drive to shift hundreds of thousands of surgeries to private companies.But you should be nervous about a plan that rests too heavily on hope and ideology.The Vancouver Island Health Authority (VIHA) is taking the lead on this effort. The authority has just asked clinics to bid on contracts to provide some 20,000 operations a year that are now being done in the public system. The provincial government expects the other health authorities to follow the same approach wherever there are enough private clinics to do the work.Patients shouldn’t really care who owns the operating room, or hires the nurses. As long as the work is done well, access remains fair and the taxpayer isn ‘t being gouged there’s no threat to the public interest or violation of the Canada Health Act.The health authorities even hope they can save money and reduce wait times. The private clinics, VIHA say, will be able to do more minor day surgery. That should free hospital operating rooms for additional major surgeries. The authorities are spared the capital expense of adding operating rooms.And the authority promises that the patients will be protected. Waiting lists will continue to function as they now do. (That is to say badly, but with relatively fair access.) The private companies will be asked to explain how they will limit the poaching of public sector health care staff they ramp up for this business boom.The big benefit should be the introduction of useful competition into the health care system.Competition is a good thing. Grocery stores compete for your business, so they spend time looking for improvements that will win your loyalty - better service, lower prices, local produce. Good ideas are rewarded; bad ideas abandoned. Consumers benefit. And that’s just as true for health care consumers as it is for grocery shoppers. (Some people balk at the idea of health care consumers. But that’s our role - we pay money in taxes and MSP premiums and get service in return.)Competition is almost entirely absent from the world of health care. If one team runs a great hospital, and another a mediocre one, they’re treated in pretty much the same way. Figure out a better way to run an emergency room and your reward is more people showing up for care, not more money or better equipment.But there are some big, legitimate concerns with the contracting-out push.For starters, the government has no idea whether this change will save money or cost more. Health Minister George Abbott acknowledges that no one really knows what it costs to do these operations in the public system. Without that, it’s impossible to make a rational decision about contracting out. The simple and obvious solution is to have the health authority set up its own day clinic and compare its costs and outcomes with private clinics. The government has not taken that basic step.It also hasn’t prepared a business plan for this enormous shift. How will public hospitals function without the minor surgeries that allowed them to make maximum use of operating rooms? What will happen if nurses or doctors decide the private clinics are better places to work? There is a real risk that critical major surgeries will be cancelled because the needed staff will be down the road doing minor surgery for a private clinic. Health authorities can now set surgical priorities; once these contracts are in place that won’t be possible.Many of these same clinics are already charging user fees for faster access to surgery, in practice many would argue is a violation of the Canada Health Act. Health authorities may be subsidizing the expansion of two-tier careA major experiment with private delivery would be valuable. This looks much more like a poorly planned and blind leap into the unknown.Footnote: One of government’s most baffling and destructive tendencies is its enthusiasm for wholesale change. Prudent managers test new ideas or approaches on a regional basis and assess results before expanding the initiative. Government - as we see again in this case - too often leaps imprudently toward the next great solution.

Monday, May 29, 2006

VICTORIA - After 14 years as Alberta premier, Ralph Klein still doesn’t have a clue about how equalization works.He's not alone. Despite all the fussing about the program, most people don't know much about it, and what they do know is likely wrong.It’s going to be a hot issue for the next few months. Here’s a five-minute primer so you‘ll be more clued in than Alberta’s premier. It’s interesting, honest.Klein scored some big headlines by threatening to pull out of the equalization program if Alberta’s resource revenues became part of the funding formula. “This is a political showdown,” he vowed.It made no sense, or no more sense than declaring that Alberta would pull the military out of Afghanistan.Klein seems to think — like lots of people — that equalization means Ottawa bills some provinces and then passes on the money to Canada’s losers, like forced charity. And he seems to think a province can opt out.But equalization is an entirely federal program. Ottawa takes some of the tax money it collects and chooses to help poor provinces deliver education and health care and other responsibilities. Alberta could urge its citizens to withhold two per cent of their federal income tax as a protest, I suppose, but there’s no real way to opt outBack in 1867 the Fathers of Confederation carved up taxing powers and responsibilities between federal and provincial governments. Ottawa got defence and major economic development initiatives; the provinces got health and education and social services.It made sense at the time, but by the Dirty Thirties things had changed. Education, for example, was a low-cost item in 1867. By 1930 providing education was already costing provinces more than they could afford. (The total cost of education and public welfare programs was less than $5 billion in 1874 and some $360 billion by 1937.)The problem hit a crisis point in the Depression, when some provincial governments faced huge demands for services they couldn’t afford to provide.The solution was to shift some responsibilities and tax powers to Ottawa. The federal government was to take the extra revenue and share it among the provinces, based in part on need. The principle was that some provinces - like Ontario - could raise lots of taxes off their large industrial base. Others struggled. The federal government would transfer enough money to ensure that every province could offer adequate services without taxing its citizens too heavily. You wouldn’t die early because you lived in New Brunswick.The current debate is about how you calculate those transfer payments. Right now the federal government looks at five provinces - Ontario, Quebec, Manitoba, Saskatchewan and B.C. - and calculates their average ability to bring in different kinds of taxes. Provinces that fall below that level get money to bring them up to the average.Perhaps, the current thinking goes, all 10 provinces, including Alberta with its big energy revenues, should be included in the calculation. That would mean total payments - from the federal government - would rise by $6 billion from the current $9.5 billion.Mostly Canadians have accepted the idea that all provinces should be able to provide basic services. It’s not a radical principle. B.C. provides some extra money for rural school districts on the same basis. But Klein is right in one way. The money has to come from somewhere. If the federal government wasn’t helping out poorer provinces, it could cut taxes or spend more on the military.The basic facts are clear, but the issues are complex. For example, B.C. got more than $800 million in equalization payments in 2004-5. Does the province really need money to deliver basic services? Would higher transfers reduce poorer provinces’ commitment to finding new economic opportunities? Or are inadequate transfers holding them down?Those are the important questions. Equalization is ultimately a balance of idealism and pragmatism. The public’s view matters.Your’re now more knowledgeable than Alberta’s premier. Footnote: The fundamental issues are fascinating. How much revenue should government collect? What share should go to the military and what share to health care? How much tougher should life be in Newfoundland? What should the provinces be able to decide and where do national standards matter? It’s an important debate.